Analysis

DadPad guide aims to help fathers adjust to caring for their baby in a neonatal unit

Fathers can feel left out and stressed when their newborn is in a neonatal unit, but a new guide is now available to help 

Fathers can feel left out and stressed when their newborn is in a neonatal unit, but a new guide is now available to help


Bryan Taylor with wife Claire and three-day-old Sonny

Bryan Taylor’s baby, Sonny, spent 12 weeks in the neonatal unit of Dorset’s Poole Hospital when he was born 18 months ago.

He had been born three months prematurely – and later had to have a heart operation. He is now healthy and happy.

But Mr Taylor says it was a ‘confusing and scary’ experience for him and his wife, Claire.

‘The staff were really good, but it’s hard to keep up with what is going on. We were in temporary accommodation so we could be close by, but I had to return to work.

‘I missed ward rounds and I would arrive after work and it could be hard to keep up with what is going on. You want to be supportive, but you don’t want to get in the way.’

His experience is not unique, says Professor Minesh Khashu, a consultant neonatologist at the hospital.

What is the neonatal DadPad?

The Neonatal DadPad was developed by consultant neonatologist Professor Minesh Khashu and Inspire Cornwall Community Interest Company with the help of a working group of health staff and fathers.

It took nine months to put together and went through 18 different iterations as it was road-tested.

The topics covered in the 40-page laminated guide include:

  • Dealing with emotions
  • Different levels of care
  • A guide to neonatal equipment
  • What commonly happens in the first few hours and days
  • Caring for your baby
  • Holding your baby
  • Looking after yourself
  • Looking after baby’s mother
  • Getting ready to go home
  • Where to go for further help

‘In neonatal care we don’t think enough about the stress dads are under. They can be separated from their family for a long time. There is a lot of bravado and men are not always good at showing emotion.

‘We talk a lot about postnatal blues for mums, but not for dads – and having a baby in neonatal care is even more stressful than normal. They can be in there for months.’

The challenges facing fathers in such situations prompted Professor Khashu to develop an aid to support them.

Working with fathers and staff locally, Professor Khashu has produced the Neonatal DadPad in partnership with Inspire Cornwall Community Interest Company, which created a DadPad for maternity services two years ago.

The pack of laminated cards contains practical information and advice from the sort of equipment used in neonatal care to how to care for your baby and partner.

Neonatal Nurses Association chair Claire O’Mara says she is pleased to see a focus on fathers.

She says neonatal care can be tough for them, but she believes the situation is beginning to change. ‘There’s been a big focus on getting dads involved more.

‘Units now encourage kangaroo care for dads – getting babies out of the incubator and enjoying some skin-on-skin contact.

‘But it takes time. The baby is still on a ventilator and when it is busy our priority has to be the babies on the units.

‘Nurses and doctors do their best, but communication and the time we have for parents can suffer. That is why having psychological support in all units would be a good thing. But that’s not the case yet.’

International study group

But Professor Khashu says this is not just an issue facing neonatal units – he believes there are lessons for all services working with babies.

He is part of an international study group, which is looking at how health systems involve fathers.

More than 40%

of hospitals had insufficient time for a new family to spend together after birth

The research has yet to be published, but early findings suggest the experiences of fathers are ‘in many ways suboptimal’ and engagement is ‘generally poor’.

It says health services need to become much better in actively promoting father-infant bonding, communicating with them and being attentive to signs of stress.

It says just like with mothers the opportunity to bond is ‘underpinned by hormonal and neurobiological changes’.

And when this happens, it has wider benefits for the health of the baby and family unit, by increasing rates of breastfeeding and strengthening the family unit.

It is an issue that the Fatherhood Institute has been campaigning on. The think tank has just published a report, called Who’s The Bloke in the Room?, on how the NHS should improve its approach to fathers.

Chief executive Adrienne Burgess says there is much work to do in antenatal services through to neonatal, maternity units and health visiting services.

Missing discussions

The research was accompanied by a poll of fathers showing many were not being addressed by name and the role of fathers ‘rarely’ or ‘never’ discussed during home visits.

More than 40% said hospitals had not allowed sufficient time for the new family to spend together after birth.

Nine in ten

fathers are present during labour and birth

(Source: Fatherhood Institute poll)

Ms Burgess says: ‘Dads are there for mums every step of the way, but staff are missing opportunities to get them involved which would benefit mum and baby in the long term.’

She says she would like to see letters and correspondence being addressed to both parents, the importance of involving dads incorporated in training and better data collection on dads – including friends and family surveys having information from both parents.

‘There is so much more we could be doing,’ she says. ‘Even simple steps can make a difference.’

There are also phone reader codes so users can download information, space to write information down and for photos to be attached so it can be kept as a memento.

Father's Day significance

The Neonatal DadPad was launched on Father’s Day and is now being used at Poole Hospital in Dorset and the Royal Cornwall Hospital Treliske.

Professor Khashu says the aim is to improve the resilience and mental health of fathers, but he also hopes it will be used by nurses and other staff to ‘prompt conversations’.

A copy of the guide has been sent to all neonatal units in the country. Further copies are available to buy at a small price to cover the cost of production. There are also plans to produce an app.

Click here for more information

What do nurses think?

Senior advanced neonatal nurse practitioner Fiona Cramb, who was part of the working group that developed the Neonatal DadPad, believes it can make a big difference.

‘Neonatal units are busy. It can be a rollercoaster ride for parents and unfortunately it is easy for dads to feel left out.

‘So, to have something that gives them the information they need in such a usable format will really help.’

But, Ms Cramb says it is not just fathers who will benefit. ‘It can be used as a resource for mum, grandparents and other family members too. It will enable parents to feel more comfortable about asking questions and also for staff in initiating conversations.’

 

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